Respiratory

Question 1

Pickwickian syndrome

Answer 1

AKA obesity hypoventilation syndrome. = presence of awake alveolar hypoventilation characterized by daytime hypercapnia (i.e. arterial CO2 > 45 mmHg) that is thought to be a consequence of diminished ventilatory drive and capacity r/t obesity (BMI >/= 30) in absence of alternate neuromuscular, mechanical or metabolic explanation for hypoventilation.

Question 2

Cheyne-Stokes breathing

Answer 2

Periods of deep breathing alternate w/ periods of apnea (no breathing). Children & aging ppl normally may show this pattern of sleep. Other causes include HFG, uremia, drug-induced respiratory depression, & brain damage (typically on both sides of cerebral hemispheres or diencephalon).

Question 3

Rapid deep breathing (Hyperpnea, Hyperventilation) (= Kussmaul breathing)

Answer 3

Rapid deep breathing = several causes, including exercise, anxiety, & metabolic acidosis. In comatose pt, consider infarction, hypoxia, or hypoglycemia affecting midbrain/ pons. Kussmaul breathing = deep breathing due to metabolic acidosis. It may be fast, normal in rate, or slow.

Question 4

Ataxic breathing (Biot’s Breathing)

Answer 4

Characterized by unpredictable irregularity. Breaths may be shallow/ deep, & stop for short periods. Causes include respiratory depression & brain damage, typically at the medullary level.